Can Bionic Eyes Restore Vision?

It is estimated that more than 2 billion people have near or distance vision impairment. Artificial vision for those with blindness became a reality in the past decade with the FDA approval of a device for those suffering from a rare cause of blindness known as retinitis pigmentosa.

Bionic eyes hold promise but do not restore normal vision, only the perception of light and reflections of light. Recently, new and improved devices have begun to undergo research and development and show promise in expanding the use of bionic eyes.

How do bionic eyes work?

Bionic eyes, also known as visual prostheses, only work if the person once had the ability to see. This is important to understand because the device relies on our natural neural and brain pathways still intact.

If there has been a disruption of that physiological network that allows vision, the implanted device cannot restore vision. In other words, if the person has lost their eye or had head trauma in an accident, the technology is not there yet to restore vision like in science fiction movies or novels.

Bionic eyes are theoretically artificial body parts that work using electromechanical means. However, at this point, they are more of an enhancement of vision when vision is no longer there. Unfortunately, they do not convey special powers or X-ray vision.

Bionic eyes are comprised of microelectrodes surgically implanted in or near one eye, the optic nerve, or the brain. The electrical stimulation works on those areas of the visual system that are still functional but not receiving the right information.

The artificial electrical stimulation delivered by microelectrodes allows for perceiving small spots of light called phosphines. Think of phosphines as seeing lights without light being there. These are the lights or colors we may see when we close our eyes or rub them and see stars.

Bionics eyes create phosphines, so the person can develop a sense of their environment. It is not natural light, but more like a series of flashes and shapes. Some people with bionic eyes are able to make sense of the information so that they can tell if another person is there. However, some people have even been able to make out images of large letters or a word on a piece of paper.

Essentially, bionic eyes take images from a video camera and convert them into a representation of contrasts in black and white. Then, from the contrasts, a video processor creates a blurred image comprised of phosphines or flashes of light.

The end result is that the person with the bionic eye sees the appearance of a meaningful visual image using the characterization of the size, shape, and location of the phosphines. With training, the person then can learn the task of interpreting what they are “seeing.”

The field of view of what a person with a bionic eye is limited to about the span of one hand at arm’s length. The person has to remember bits and pieces of the images and learn how to put them together into something that makes sense, such as a door opening or a person approaching.

The miracle is that the bionic eye allows someone who has nothing the opportunity to gain awareness of their environment. The limitations are outweighed by the benefits for most dedicated bionic eye users, particularly if they can sense obstacles.

Newer technology promises to add distance-sensing cameras and thermal images. Overall, the outcome, like with cochlear implants, depends on the commitment, dedication, and motivation of the person who obtains a bionic eye implant.

Who can get a bionic eye?

The short answer is not everyone. The FDA approved the bionic eye for humanitarian reasons, and it is limited in scope to only a few people each year.

The cost of the bionic eye device may exceed $150,000 for just the implant and the accessories. The hospital and doctor fees, surgical interventions, training, or lengthy visual rehabilitation are additional but typically covered at least partially by medical insurance.

To be considered as a candidate for a bionic eye, the person must meet the specific criteria of the FDA, which include:

• Adults ages 25 and older;
• Bare or no light perception in both eyes;
• Previous history of useful form vision;
• Aphakic or pseudophakic (no lens in the eye);
• Willing and able to receive the recommended post-implant clinical follow-up, device fitting, and visual rehabilitation.

Are bionic eyes still available?

The Argus II implant was developed as the world’s first FDA-approved prosthetic retina implant for patients with blindness due to retinitis pigmentosa. The FDA approved the device to provide retinal electrical stimulation to induce visual perception in blind patients with bare light or no light perception in both eyes.

Second Sight, however, had abandoned the technology in 2020 and was on the verge of going bankrupt. Fortunately, today the new company, Vivian Medical, Inc., has taken the reins and has introduced a new experimental version of bionic eyes called the Orion II, a follow-on version of their Orion Visual Cortical Prosthesis System.

The Orion II system will potentially expand the capability of bringing meaningful artificial vision to blindness from a wide range of causes, including glaucoma, diabetic retinopathy, optic nerve injury or disease, or even cancer or trauma.

Bionic eyes have been around for more than a decade. The concept of replacing vision when there is blindness has, so far, been limited to those suffering from the rare eye disease retinitis pigmentosa. The results have been limited to only light or flashes of light, not what everyone would consider normal vision. The future is promising. Technology is advancing. Perhaps, science fiction will one day become reality for those with all types of blindness.